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Journal of Pain & Palliative Care Pharmacotherapy

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https://www.readbyqxmd.com/read/28436710/ischemic-ulcer-pain-is-both-nociceptive-and-neuropathic-pain-based-on-a-discriminant-function-analysis-using-the-mcgill-pain-questionnaire
#1
Takamichi Kogure, Masahiko Sumitani, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuhito Mietani, Kazuo Kawahara, Yoshitsugu Yamada
The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of 365 patients with NeP and 124 with NocP using the 78 words of the MPQ...
April 24, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28388238/oral-versus-topical-diclofenac-sodium-in-the-treatment-of-osteoarthritis
#2
Vinicius Tieppo Francio, Saeid Davani, Chris Towery, Tony L Brown
Osteoarthritis (OA) is one of the most common causes of joint pain in the United States and non-steroidal anti-inflammatories (NSAIDs), such as Diclofenac sodium, which is currently available in two main routes of administration; oral and topical distribution have been established as one of the standard treatments for OA. Generally, oral NSAIDs are well tolerated; however our narrative review suggests that the topical solution had a better tolerability property than oral Diclofenac sodium, especially due to side effects of gastrointestinal bleeding with the utilization of the oral format...
April 7, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28379050/pathophysiology-of-trigger-points-in-myofascial-pain-syndrome
#3
Sarah Money
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered...
April 5, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28375794/the-risks-of-chronic-corticosteroid-exposure
#4
Sarah Money
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. This article focuses on the use of corticosteroids to decrease inflammation and treat painful conditions as well as their long-term side effects and risks. Their long-term use can expose the body to side effects and can cause long-term health concerns. It therefore is important to be aware of the risks of long-term corticosteroid use...
April 4, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#5
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
April 4, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28358257/effectiveness-of-corticosteroid-monotherapy-for-dyspnea-relief-in-patients-with-terminal-cancer
#6
Tsuyoshi Maeda, Toru Hayakawa
Dyspnea is a common symptom in patients with cancer, particularly those with late-stage terminal disease. It markedly affects terminal cancer patients, reducing their quality of life. Reduced quality of life also affects survival; therefore, dyspnea is a prognostic factor. However, the role of corticosteroids, which often are used to alleviate dyspnea, has not been sufficiently validated. In this study, we retrospectively investigated whether corticosteroid monotherapy was effective for dyspnea palliation. The effectiveness rate of corticosteroid therapy was 45% in nine male and two female study subjects (mean age: 74...
March 30, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28358229/intractable-acute-pain-related-to-fluoroquinolone-induced-peripheral-neuropathy
#7
Matthew Dukewich, Arash Danesh, Chiemeka Onyima, Anita Gupta
Fluoroquinolones are widely prescribed antibiotics, used for various infectious etiologies. These antibiotics carry the possibility of the serious adverse effect of peripheral neuropathy, with a true incidence not known owing to its rare existence. Recently, the Food and Drug Administration (FDA) has required alterations to drug labels to highlight this adverse effect of fluoroquinolones. This is a case report of a single patient at an inpatient neurology service at an urban academic medical center in the United States...
March 30, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28346035/one-needle-is-better-than-two-the-philosophy-surrounding-use-of-local-anesthesia-in-northern-india
#8
Maria Story
The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28346017/strong-in-the-face-of-adversity
#9
Simoni Binoy
Palliative care provides holistic care to individuals in life-threatening or life-limiting conditions. This narrative describes the journey of Kanchan. A strong lady and a doting mother, she came to the hospital by choice, in immense pain and with swelling. Her narrative illustrates how the palliative approach draws out the inner strengths of individuals by focusing on their issues and needs. Kanchan was able to benefit from physiotherapy to reduce the risk of lymphoedema after surgery for breast cancer. Her narrative illustrates how she found comfort and relief, ably supported by the dedicated hospital team...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287363/nebulized-fentanyl-for-dyspnea-in-a-hospice-patient-with-true-allergy-to-morphine-and-hydromorphone
#10
Robert G Wahler, David B Smith, Kimberly B Mulcahy
An 86-year-old white female was admitted to hospice care with lung cancer. Even with optimal medical management, she suffered from dyspnea and required opioid therapy. However, the patient had a true morphine and hydromorphone allergy. She was administered nebulized fentanyl for symptomatic relief of dyspnea with good effect and she did not experience any allergic response.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287362/drug-costs-the-controversy-continues
#11
Arthur G Lipman
No abstract text is available yet for this article.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287361/believing-jeny-about-her-pain
#12
M S Biji
A 19-year-old woman with cancer and excruciating pain was not easily responding to morphine. Some of the staff suspected that this pain was not physical, that it was all emotional. But when the palliative care team believed the young woman's report of her pain, they were able to arrive at the right combination of medicines to treat her pain, and to relieve her intolerable suffering.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287360/an-educational-intervention-to-decrease-drug-costs-related-to-terminal-secretions-in-a-hospice-organization
#13
Cara Brock, Sarah Cooper, Christopher M Herndon
Terminal secretions is a common symptom seen in hospice patients. Antimuscarinic drugs are commonly used to treat this symptom despite a lack of supporting data. Wide variability in cost exists among these treatments. Hospice program data were assessed to identify high-use and high-cost medications. An educational intervention (EI) was developed to target one such medication, transdermal scopolamine. The EI focused on efficacy, safety, and actual cost (by unit and total expenditure) for each possible treatment of terminal secretions...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287359/opioid-prescribing-patterns-and-costs-in-a-large-group-of-patients-in-colombia
#14
Jorge Enrique Machado-Alba, Andres Gaviria-Mendoza, Camila A Vargas-Mosquera, Andrés Felipe Gil-Restrepo, Luis C Romero-Zapata
The potential for development of tolerance and dependence and the risk of side effects of opioids make it necessary to monitor their prescribing patterns in order to decrease the morbidity and mortality associated with their continued use. The objective of this study was to determine prescription patterns of opioid medication in a group of patients through a cross-sectional study on a population database of 3.5 million people. Patients with three months of continuous opioid use were identified. Pharmacological, co-medication and cost variables were analyzed...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287358/intractable-neck-pain-in-an-oncologic-palliative-care-setting-is-cancer-always-the-answer
#15
Valentina Delfine, Enos Bernasconi, Donata Bardelli, Vito Spataro, Tanja Fusi-Schmidhauser
Refractory pain is a common manifestation in an oncologic palliative care setting and represents a major challenge for health care professionals involved in care provision. The underlying neoplasm and its dissemination are the foremost pathophysiologic mechanism for the development of pain in patients with advanced cancer. Nonetheless, other etiologies such as trauma and infections need to be considered by clinicians in this particular care setting. The authors present the case of a patient with a recent diagnosis of hepatocellular carcinoma, suffering from intractable neck pain, progressive worsening of her general conditions, and the onset of a generalized seizure...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287357/a-review-of-agents-for-palliative-sedation-continuous-deep-sedation-pharmacology-and-practical-applications
#16
John Bodnar
Continuous deep sedation at the end of life is a specific form of palliative sedation requiring a care plan that essentially places and maintains the patient in an unresponsive state because their symptoms are refractory to any other interventions. Because this application is uncommon, many providers may lack practical experience in this specialized area and resources they can access are outdated, nonspecific, and/or not comprehensive. The purpose of this review is to provide an evidence- and experience-based reference that specifically addresses those medications and regimens and their practical applications for this very narrow, but vital, aspect of hospice care...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287356/range-of-effective-corticosteroid-doses-for-alleviating-dyspnea-in-terminal-cancer-patients-a-retrospective-review
#17
Tsuyoshi Maeda, Toru Hayakawa
This study aimed to determine the range of mean cumulative corticosteroid doses that could effectively palliate dyspnea in opioid-treated patients with terminal cancer and to investigate the demographic or biochemical factors predictive of corticosteroid responsiveness. To this end, responders and nonresponders were compared with regard to corticosteroid dose and whether they had initiated opioid use before or concomitantly with corticosteroid use. A logistic regression analysis was conducted to assess the impacts of demographic and biochemical factors on corticosteroid effectiveness...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287355/donepezil-an-acetylcholinesterase-inhibitor-can-attenuate-gabapentinoid-induced-somnolence-in-patients-with-neuropathic-pain-a-retrospective-chart-review
#18
Takamichi Kogure, Masahiko Sumitani, Kiyoshi Ikegami, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuo Kawahara, Yoshitsugu Yamada
Donepezil, an oral acetylcholinesterase inhibitor, is used to treat Alzheimer's disease and reportedly attenuates opioid-induced sedation in patients with cancer pain. Neuropathic pain is often treated with gabapentinoids (pregabalin, gabapentin), but gabapentinoid-induced somnolence sometimes prevents patients from using these agents. We conducted a retrospective chart review of patients with neuropathic pain to examine whether donepezil is useful for gabapentinoid-induced somnolence. We investigated pain severity in 13 patients before and after taking gabapentinoids and donepezil, the degree of gabapentinoid-induced somnolence before and after starting donepezil, and gabapentinoid dose escalation after taking donepezil...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287354/systematic-reviews-published-in-the-october-2016-issue-of-the-cochrane-library
#19
Philip J Wiffen
The Cochrane Library of Systematic Reviews has been published quarterly as a DVD and monthly online ( http://www.thecochranelibrary.com ). The final October 2016 issue (4th DVD for 2016) contains 7068 complete reviews and 2467 protocols for reviews in production. In addition, there are citations of 973,000 randomized controlled trials, and 15,700 cited papers in the Cochrane Methodology Register. The Health Technology Assessment database contains some 16,000 citations. One hundred and seventeen new reviews have been published in the previous 3 months, of which three have potential relevance for practitioners in pain and palliative medicine...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287353/new-online-tool-for-exploring-global-opioid-consumption-data
#20
Martha A Maurer
Each year for nearly two decades, the Pain & Policy Studies Group (PPSG) has received from the International Narcotics Control Board, the global monitoring body for the implementation of the United Nations international drug control conventions, consumption data for six principal opioids used to treat moderate and severe pain: fentanyl, hydromorphone, methadone, morphine, oxycodone, and pethidine. To provide these statistics to a wider audience, PPSG developed an extensive section of its Web site featuring these data in the form of global, regional, and individual country graphs...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
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